Individual provider · Type 1 NPI
Latisha Shanta Lewis, M.A.T.
Developmental Therapist · Belleville, IL
Practice location
1948 Richmond Springs Ln
Belleville, IL 62220-3283
Fax (618) 825-0210
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Therapist Primary | 222Q00000X | L200-5377-9925 (IL) |
Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…
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About NPI 1013297431
Latisha Shanta Lewis, M.A.T.'s National Provider Identifier is 1013297431, issued on Aug 17, 2011. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Belleville, IL. The record was last updated on Aug 17, 2011.